Short-term effectiveness of femoral neck system in the treatment of femoral neck fracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Yajun , MA Tao , ZHANG Xiaoyu , LUO Xiaojun , FAN Tao ,  WANG Yuhai

Orthopedics Center, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan Ningxia, 750001, P.R.China;

Corresponding?author：

WANG Yuhai, Email: 398672611@qq.com

Keywords：

Femoral neck fracture; femoral neck system; cannulate screw; internal fixation

DOI：

10.7507/1002-1892.202012097

Video：

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Objective To investigate the short-term effectiveness of femoral neck system (FNS) in the treatment of femoral neck fracture.Methods The clinical data of 34 patients with femoral neck fracture admitted between January 2019 and April 2020 who met the selection criteria were retrospectively analyzed and divided into group A (19 patients were treated with conventional cannulated screw internal fixation) and group B (15 patients were treated with FNS internal fixation) according to the different methods of internal fixation. There was no significant difference between the two groups in general data such as gender, age, affected side, cause of injury, fracture type, and time from injury to operation (P>0.05). The operation time, intraoperative blood loss, fluoroscopy frequency, and fracture healing time were recorded and compared between the two groups. X-ray film and CT examinations were performed postoperatively to evaluate fracture reduction and internal fixation, and the shortening of the femoral neck on the affected side was measured compared with that on the healthy side. The Harris score was used to evaluate hip function.Results There was 1 unsatisfied reduction case in groups A and B respectively, the rest of the patients in both groups were obtained satisfied reduction. There was no significant difference in the quality of reduction between the two groups (Z=–0.195, P=0.854). There was no significant difference in operation time between the two groups (t=0.649, P=0.064). The intraoperative blood loss in group A was significantly less than that in group B, and the fluoroscopy frequency was significantly more than that in group B, with significant differences (P<0.05). Except for 1 case in group A with screw out at 3 months after operation and no obvious callus formation, all fractures in the two groups reached clinical healing, and there was no significant difference in fracture healing time between the two groups (t=–0.127, P=0.899). There was no necrosis of femoral head in the two groups. At last follow-up, there were 4 cases of femoral neck shortening in group A and 2 cases in group B. The hip function of both groups recovered well, and there was no significant difference in Harris score at last follow-up (t=0.956, P=0.346).Conclusion The treatment of femoral neck fracture using FNS has less trauma. Compared with cannulated screw internal fixation, it can reduce the intraoperative fluoroscopy frequency and obtain satisfactory short-term effectiveness.

Citation： YANG Yajun, MA Tao, ZHANG Xiaoyu, LUO Xiaojun, FAN Tao, WANG Yuhai. Short-term effectiveness of femoral neck system in the treatment of femoral neck fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(5): 539-543. doi: 10.7507/1002-1892.202012097 Copy

1.	Florschutz AV, Langford JR, Haidukewych GJ, et al. Femoral neck fractures: current management. J Orthop Trauma, 2015, 29(3): 121-129.
2.	Schopper C, Zderic I, Menze J, et al. Higher stability and more predictive fixation with the Femoral Neck System versus Hansson Pins in femoral neck fractures Pauwels Ⅱ. J Orthop Translat, 2020, 24: 88-95.
3.	范智榮, 蘇海濤, 周霖, 等. 新型股骨頸內固定系統治療不穩定性股骨頸骨折的有限元分析. 中國組織工程研究, 2021, 25(15): 2321-2328.
4.	Campenfeldt P, Hedstr?m M, Ekstr?m W, et al. Good functional outcome but not regained health related quality of life in the majority of 20-69 years old patients with femoral neck fracture treated with internal fixation: A prospective 2-year follow-up study of 182 patients. Injury, 2017, 48(12): 2744-2753.
5.	蔡樂益, 郭曉山, 鄭文浩, 等. 對Garden指數作為股骨頸骨折復位質量評價標準的再認識. 中華創傷骨科雜志, 2020, 22(3): 232-237.
6.	劉克敏, 曲鐵兵. 重視老年髖部骨折治療和康復模式轉變. 中華創傷雜志, 2018, 34(7): 577-579.
7.	李建濤, 張里程, 徐高翔, 等. 股骨近端三角形結構重建失效對骨折手術失敗的影響. 中華骨科雜志, 2020, 40(14): 928-935.
8.	畢鄭剛, 王旭明. 再談老年股骨頸骨折的手術治療策略. 中華外科雜志, 2019, 57(11): 804-806.
9.	楊宗酉, 邢欣, 張奇, 等. 股骨頸骨折診斷和治療關鍵技術研究進展. 中華創傷雜志, 2014, 30(3): 274-276.
10.	Duffin M, Pilson HT. Technologies for young femoral neck fracture fixation. J Orthop Trauma, 2019, 33 Suppl 1: S20-S26.
11.	Slobogean GP, Stockton DJ, Zeng BF, et al. Femoral neck shortening in adult patients under the age of 55 years is associated with worse functional outcomes: Analysis of the prospective multi-center study of hip fracture outcomes in China (SHOC). Injury, 2017, 48(8): 1837-1842.
12.	Li M, Cole PA. Anatomical considerations in adult femoral neck fractures: how anatomy influences the treatment issues? Injury, 2015, 46(3): 453-458.
13.	Panteli M, Rodham P, Giannoudis PV. Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly. Injury, 2015, 46(3): 445-452.
14.	Stoffel K, Zderic I, Gras F, et al. Biomechanical evaluation of the femoral neck system in unstable pauwels Ⅲ femoral neck fractures: A comparison with the dynamic hip screw and cannulated screws. J Orthop Trauma, 2017, 31(3): 131-137.
15.	Li J, Zhao Z, Yin P, et al. Comparison of three different internal fixation implants in treatment of femoral neck fracture-a finite element analysis. J Orthop Surg Res, 2019, 14(1): 76.
16.	Ye Y, Chen K, Tian K, et al. Medial buttress plate augmentation of cannulated screw fixation in vertically unstable femoral neck fractures: Surgical technique and preliminary results. Injury, 2017, 48(10): 2189-2193.
17.	許新忠, 常菁, 余水生, 等. 股骨頸系統固定治療股骨頸骨折的近期療效分析. 中華創傷骨科雜志, 2020, 22(7): 624-627.
18.	Weil YA, Qawasmi F, Liebergall M, et al. Use of fully threaded cannulated screws decreases femoral neck shortening after fixation of femoral neck fractures. Arch Orthop Trauma Surg, 2018, 138(5): 661-667.
19.	李海波, 許圣茜, 湯雪霞, 等. 術前牽引對股骨頸骨折術后發生股骨頭缺血性壞死的影響研究. 中國修復重建外科雜志, 2019, 33(6): 671-675.
20.	李偉龍, 余霄, 龐清江. 股骨頸骨折內固定術后股骨頸短縮的相關研究進展. 中華骨科雜志, 2016, 36(6): 378-384.

1. Florschutz AV, Langford JR, Haidukewych GJ, et al. Femoral neck fractures: current management. J Orthop Trauma, 2015, 29(3): 121-129.
2. Schopper C, Zderic I, Menze J, et al. Higher stability and more predictive fixation with the Femoral Neck System versus Hansson Pins in femoral neck fractures Pauwels Ⅱ. J Orthop Translat, 2020, 24: 88-95.
3. 范智榮, 蘇海濤, 周霖, 等. 新型股骨頸內固定系統治療不穩定性股骨頸骨折的有限元分析. 中國組織工程研究, 2021, 25(15): 2321-2328.
4. Campenfeldt P, Hedstr?m M, Ekstr?m W, et al. Good functional outcome but not regained health related quality of life in the majority of 20-69 years old patients with femoral neck fracture treated with internal fixation: A prospective 2-year follow-up study of 182 patients. Injury, 2017, 48(12): 2744-2753.
5. 蔡樂益, 郭曉山, 鄭文浩, 等. 對Garden指數作為股骨頸骨折復位質量評價標準的再認識. 中華創傷骨科雜志, 2020, 22(3): 232-237.
6. 劉克敏, 曲鐵兵. 重視老年髖部骨折治療和康復模式轉變. 中華創傷雜志, 2018, 34(7): 577-579.
7. 李建濤, 張里程, 徐高翔, 等. 股骨近端三角形結構重建失效對骨折手術失敗的影響. 中華骨科雜志, 2020, 40(14): 928-935.
8. 畢鄭剛, 王旭明. 再談老年股骨頸骨折的手術治療策略. 中華外科雜志, 2019, 57(11): 804-806.
9. 楊宗酉, 邢欣, 張奇, 等. 股骨頸骨折診斷和治療關鍵技術研究進展. 中華創傷雜志, 2014, 30(3): 274-276.
10. Duffin M, Pilson HT. Technologies for young femoral neck fracture fixation. J Orthop Trauma, 2019, 33 Suppl 1: S20-S26.
11. Slobogean GP, Stockton DJ, Zeng BF, et al. Femoral neck shortening in adult patients under the age of 55 years is associated with worse functional outcomes: Analysis of the prospective multi-center study of hip fracture outcomes in China (SHOC). Injury, 2017, 48(8): 1837-1842.
12. Li M, Cole PA. Anatomical considerations in adult femoral neck fractures: how anatomy influences the treatment issues? Injury, 2015, 46(3): 453-458.
13. Panteli M, Rodham P, Giannoudis PV. Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly. Injury, 2015, 46(3): 445-452.
14. Stoffel K, Zderic I, Gras F, et al. Biomechanical evaluation of the femoral neck system in unstable pauwels Ⅲ femoral neck fractures: A comparison with the dynamic hip screw and cannulated screws. J Orthop Trauma, 2017, 31(3): 131-137.
15. Li J, Zhao Z, Yin P, et al. Comparison of three different internal fixation implants in treatment of femoral neck fracture-a finite element analysis. J Orthop Surg Res, 2019, 14(1): 76.
16. Ye Y, Chen K, Tian K, et al. Medial buttress plate augmentation of cannulated screw fixation in vertically unstable femoral neck fractures: Surgical technique and preliminary results. Injury, 2017, 48(10): 2189-2193.
17. 許新忠, 常菁, 余水生, 等. 股骨頸系統固定治療股骨頸骨折的近期療效分析. 中華創傷骨科雜志, 2020, 22(7): 624-627.
18. Weil YA, Qawasmi F, Liebergall M, et al. Use of fully threaded cannulated screws decreases femoral neck shortening after fixation of femoral neck fractures. Arch Orthop Trauma Surg, 2018, 138(5): 661-667.
19. 李海波, 許圣茜, 湯雪霞, 等. 術前牽引對股骨頸骨折術后發生股骨頭缺血性壞死的影響研究. 中國修復重建外科雜志, 2019, 33(6): 671-675.
20. 李偉龍, 余霄, 龐清江. 股骨頸骨折內固定術后股骨頸短縮的相關研究進展. 中華骨科雜志, 2016, 36(6): 378-384.

Chinese Journal of Reparative and Reconstructive Surgery

Short-term effectiveness of femoral neck system in the treatment of femoral neck fracture

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